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Clinicians' Perspective in the Use and Adaptability of the Latest Methods of Diagnosis and Treatment for Cancers in Women
Published in Shazia Rashid, Ankur Saxena, Sabia Rashid, Latest Advances in Diagnosis and Treatment of Women-Associated Cancers, 2022
Thermal ablation and magnetic hyperthermia are currently used in treating neoplastic tissues. Thermal ablation uses a temperature lower than −40°C or higher than 60°C for long exposure to damage a tumour cell. Hypothermic ablation occurs due to the formation of ice crystals upon cooling, which destroys cell membranes and kills cells. Radiofrequency ablation (RF ablation) is the most popular in clinics because of its efficacy and safety. It uses an alternative current of RF waves to a target zone by an insulated electrode tip and the interaction of the current causes the oscillation of ions in the extracellular fluid which produces heat. Ablation of the T-zone with cryotherapy has been highly successful in curing cervical cancers, as has been reported in a recent Cochrane systematic review, which reports the rate of success in cryotherapy to treat CIN 3 lesions up to 93% [18]. Magnetic hyperthermia is another new way to heat tumour tissues which exploits superparamagnetic or ferromagnetic nanoparticles capable of generating heat after stimulation with an alternating magnetic field [19].
Surgery For Metastatic and Locally Advanced Thyroid Cancer
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
In treating the lateral compartment, full clearance of Levels Ila, III, IV, and Vb is the treatment of choice. Where extranodal extension affects vascular or neural structures, the surgical strategy should balance surgical morbidity with patient age and tumour biology. Where nodal disease recurs after previous surgery, revision surgery can be considered, following similar principles. In general, unless nodal disease is over 10 mm, a surveillance strategy is advised. Radiotherapy should seldom if ever be considered, and adjuvant treatments, such as radioiodine, alcohol injection, and radiofrequency ablation, can be considered for low-volume recurrence
Hepatocellular Carcinoma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Daniel H. Palmer, Philip J. Johnson
Image-guided ablation is regarded as the best therapeutic option for patients with small HCC not suitable for resection or transplantation. Treatment is usually performed percutaneously under ultrasound or CT guidance. Several methods for tumor destruction have been used, the most widely studied being percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA). The injection of 90 per cent ethanol under ultrasound guidance is technically straightforward, inexpensive, safe, and results in 5-year survival of 50 per cent in Child A, 30 per cent in Child B, but less than 10 per cent in Child C cirrhotics.49 Complete tumor necrosis is achieved in 70 per cent of tumors less than 3 cm in diameter, but this falls with increasing size (50 per cent in lesions 3–5 cm), probably due to the inability of the injected volume to disperse evenly throughout larger tumors that may contain fibrous septae. Radiofrequency ablation is a localized thermal treatment producing tumor destruction by heating a probe inserted into the tumor to temperatures exceeding 50°C, which can be performed percutaneously under image guidance, laparoscopically or at laparotomy.
Evaluation of percutaneous adhesiolysis for the management of chronic pain due to post spine surgery syndrome
Published in Egyptian Journal of Anaesthesia, 2023
Salah Mostafa Asida, Saeid Elsawy, Mahmoud Faisal, Ossama Hamdy
Minimally invasive procedures are another line for treatment; it includes epidural steroid injections (ESIs) and epidural injections, these two procedures are the most performed surgery in pain clinics worldwide [5]. There are three primary approaches for administering treatments for radiculopathy; transforaminal, interlaminar or caudally. Radiofrequency ablation is often used to produce long-lasting relief that diagnostic blocks or injections cannot achieve. Spinal cord stimulation has shown potential in managing FBSS. Lysis of adhesions can improve baseline pain scores and drug delivery of ESI, which is done by the delivery of hyaluronidase combined with hypertonic saline into the epidural space. Combining hyaluronidase with steroid may be more efficient and have linger impact than either one solely.
Biomechanical comparison of vertebral augmentation and cement discoplasty for the treatment of symptomatic Schmorl’s node: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Kaiwen Cai, Zhang Zhang, Kefeng Luo, Feng Cao, Bin Lu, Yuanhua Wu, Hongxia Wang, Kai Zhang, Guoqiang Jiang
Refractory low back pain (LBP) caused by symptomatic Schmorl’s nodes is still a thorny problem in clinical practice. In general, symptomatic Schmorl’s nodes is usually combined with endplate osteochondritis, many studies have proved that symptomatic Schmorl’s nodes have obvious correlation with abnormal MRI signals in the bone marrow (i.e. Modic type I or type II changes) around it (Takatalo et al. 2012; Luoma et al. 2016). Degression or chronic injury of subchondral microvascular may be its pathological basis, leading to the loss of nutrition and local collapse of the endplate (Nachemson et al. 1970). After endplate ruptured and nucleus intravertebral herniation, continued chemical, and pressure stimulation from the disc usually results in a poor response to conservative treatment. Such as steroid injection, anti-TNFα antibody, antibody, and bisphosphonate, have all been proved lack of long-term benefits (Dudli et al. 2016). On the other hand, the evidence for long-term efficacy of radiofrequency ablation is also mixed (Leggett et al. 2014). Alternatively, lumbar fusion surgery has been shown to offer good long-term results (Peng et al. 2009), however, the resulting loss of motion and potential risks to adjacent segments are significant concerns. Thus, alternative minimally invasive treatments have been explored.
Cryoablation as a first-line therapy for atrial fibrillation: current status and future prospects
Published in Expert Review of Medical Devices, 2022
Jason G. Andrade, Marc W. Deyell, Marc Dubuc, Laurent Macle
In contrast to focal point-by-point catheters, the cryoballoon device has the advantage of being less reliant on operator experience, reliably producing durable isolation of the arrhythmogenic muscular pulmonary venous sleeves as well as the antral pulmonary venous region responsible for arrhythmia perpetuation [30,38]. Despite variability in the operator skillset, cryoballoon ablation has been noted to have a high acute procedural success (>98% of patients achieving complete PVI) with excellent long-term freedom from recurrent AF [39–41]. Compared to radiofrequency ablation, cryoballoon ablation has been associated with a significantly lower incidence of pericardial effusion (0.8% cryoballoon vs. 2.1% radiofrequency; OR 0.44; 95% CI 0.28–0.69) and tamponade (0.4% cryoballoon vs. 1.4% radiofrequency; OR 0.31; 95% CI 0.15–0.64) but a significantly greater incidence of cold-induced phrenic nerve injury (1.7% cryoballoon vs. 0.0% radiofrequency; OR 7.40; 95% CI 2.56–21.34) [39–42]. Despite the use of a large deflectable sheath, there does not appear to be a significant difference in the incidence of peripheral vascular complications with cryoballoon ablation (1.1% cryoballoon vs. 1.3% radiofrequency; OR 0.79; 95% CI 0.38–1.62). As such, the balance of safety, efficacy, and generalizability suggest that cryoballoon ablation may be a preferred first-line ablation toolset, as it enables greater procedural standardization [43] with more consistent clinical outcomes [30].